Electronic data produce paper cuts

A digital alternative to paper

If users won't move from to paper to digital technology, why not digitize the paper itself? That approach, taken by Talario LLC's Xpaper signature-capture system, creates a digital copy of the physical document without requring it to be scanned.

Xpaper includes a digital pen and paper that carries a unique identifier and a grid pattern that orients the pen on the page. "You print on our special paper, and when you write with our pen and dock it, you get a digital copy," says Tim Aughenbaugh, president of Talario. The user creates a form in any Windows application and converts it to PDF format. When the signature is captured, it is embedded into that document.

Xpaper isn't a substitute for a signed document but supplements it, says Aughenbaugh. Xpaper creates a digital image in one step, eliminating the need to scan a document. And unlike a scan, the PDF file containing the signature is searchable. The technology is innovative, but at 15 cents per sheet, "I wonder if it isn't a solution in search of a problem," says Merilyn Dunn, an analyst at InfoTrends/CAP Ventures.

But the technology is ideal for some transactions, says Aughenbaugh: "We can retain the paper and gain the efficiencies of reporting faster or being able to bill faster."

Sonora Quest Lab works around doctors' paper habit

Sonora Quest Laboratories' efforts to automate a paper-based process required it to help doctors generate paper copies of test results. Four years ago, all of the 50,000 test requests the medical testing lab received from doctors each day arrived on paper. Today, that number has been reduced by about half. The lab, which serves patients and doctors in Arizona, created a Web-based interface that doctors can use to requisition tests and view results. The system also generates a "held order card" the doctor gives to the patient. The card includes the appointment time and a reference number that staffers in the patient service center can use to bring up the electronic order when the patient arrives for lab work.

Since most doctors work in small offices of three or fewer practitioners and many still don't have computers or Internet access, Sonora Quest offered to install PCs and printers in those offices that are dedicated to running its electronic ordering and results system. "It's a totally locked-down system. The physician doesn't have to pay for it, but it can't be used for anything else" other than lab orders and results, says Bob Dowd, CIO at Laboratory Sciences of Arizona, which manages seven hospital labs and subsidiary Sonora Quest Laboratories.

Even with those measures, some doctors continue to use paper, so Sonora Quest images those requisitions when they're presented at one of its service centers. The staff views the image on screen and manually transposes the data into the system.

"One of the first things we did was create a workflow and billing system," says Dowd. "Everything passes from queue to queue. There is no more paper." The configuration includes two server clusters and an image archive that resides on a network-attached storage device.

One cluster functions as the workflow server, while the second runs other applications. Staffers using the system can view a requisition and image at each step as the job and bar-coded lab specimens are processed. "We're no longer sending paper around the building," Dowd says.

Disseminating results presented a different challenge. With the new system, about 95% of tests received overnight are completed, and their results are available for electronic delivery by 8 a.m. With a traditional courier service, doctors didn't receive the results until later in the day. The new system lets offices view results on a secure Web site or receive them by fax right away. In some offices, Sonora has even provided a remote printer and delivers results to it. "We monitor those, so if for any reason it doesn't go through, we call the client" to resolve the problem, Dowd says.

The new system benefits everyone, he says. Patients see fewer billing errors, doctors get results more quickly, and the lab turns around orders more quickly and avoids costly billing errors. Dowd would like to move to electronic invoicing next but faces the challenge of working with a large number of vendors. Unfortunately, he says, "most of them are still trading pieces of paper."

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